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About Substance Use Disorder Clinical Care

    Substance Use Disorder Clinical Care (SUDCC) previously called ASAP-Rehab is the Army's model for providing outpatient substance use disorder treatment and other behavioral health care that is integrated, unit-aligned and co-located.
    SUDCC includes assessment, treatment and aftercare for service members and other beneficiaries within an integrated medical and behavioral health model to enhance health and readiness. The comprehensive fully integrated, unit-aligned, co-located substance use disorder treatment services follow national best practices to improve care delivery, treatment outcomes and force conservation.
    SUDCC provides substance use disorder treatment as part of a comprehensive plan to address total behavioral health needs and integrates care that improves successful rapid recovery and returns service members to full readiness status by:
  • Integrating SUDCC with the Behavioral Health System of Care (BHSOC).
  • Unit-aligning and co-locating care to improve access and continuity of care.
  • Using the Behavioral Health Data Portal (BHDP) to track and improve substance use disorder clinical outcomes.
  • Using the Behavioral Health Service Line (BHSL) capabilities and performance tools to improve value.
  • Partnering with command teams to ensure safety and maintain readiness.
  • Continuing to transform from a program-oriented model to a recovery-oriented model.
    Contact your local military treatment facility, behavioral health department or TRICARE for information about early intervention and treatment for substance use-related issues.


    Fentanyl is a synthetic opioid that the Food and Drug Administration approved as an analgesic (pain reliever) and anesthetic. It is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic.
    Fentanyl was first introduced as an intravenous anesthetic in the 1960s. It is legally manufactured and distributed in the United States but is frequently abused and distributed illicitly by patients, physicians and pharmacists.
    Fentanyl is frequently mixed into other drugs to manufacture a cheaper product; however, due to the strong potency, the combination of substances can quickly result in an accidental overdose and unexpected death. Even in very small doses, fentanyl can be deadly. According to CDC data, synthetic opioids (primarily fentanyl) contributed to 62 percent of overdose deaths in 2020.

People can take fentanyl in the following ways:
  • Injection
  • Snorting/sniffing
  • Smoking
  • Orally, as a pill or tablet
  • Spiked onto blotter paper
  • Patch

Effects include:
  • Relaxation
  • Euphoria
  • Pain relief
  • Sedation
  • Confusion
  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Urinary retention
  • Pupillary constriction
  • Respiratory depression

Overdose effects include:
  • Stupor
  • Changes in pupil size
  • Cold and clammy skin
  • Cyanosis
  • Coma
  • Respiratory failure leading to death

Tetrahydrocannabinol (THC) and cannabidiol (CBD)


    Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two natural compounds found in cannabis (marijuana). THC and CBD have the same mon b lecular structure (21 carbon atoms, 30 hydrogen atoms and 2 oxygen atoms), but their structures are arranged differently and have different effects on body.

    THC gives the “high” and binds to the C1 receptors in the brain. CBD weakly attaches to the same receptors but does not produce the feeling of euphoria, and it can dampen the high from THC.

    THC is used to help with conditions including:

    • Pain
    • Muscle spasticity
    • Glaucoma
    • Insomnia
    • Low appetite
    • Nausea
    • Anxiety

    CBD is used to help with conditions including:

    • Seizures
    • Inflammation
    • Pain
    • Psychosis or mental disorders
    • Inflammatory bowel disease
    • Nausea
    • Migraines
    • Depression
    • Anxiety

Prescription Drugs

    It is dangerous for people to use medications that were not prescribed to them or use outdated medication.

    Everyone’s body chemistry is different. What a doctor prescribes for one person may not be appropriate for someone else, and the outcome of taking an unprescribed medication could be fatal.

    Taking outdated medication (typically one year from the fill date) can be just as dangerous as taking unprescribed medication. Expired medications can change chemical composition; there is also a risk of bacterial growth.

    Body chemistry can also change (including weight), which could affect the proper dose and lead to a dangerous outcome. There could be counterindications with other medications and cause unexpected reactions or other serious issues.


    Street names: “Tranq”, “Tranq dope”, “Philly dope”, “sleep cut” and “zombie drug”

    Xylazine is a medication that belongs to a class of drugs known as alpha-2 adrenergic agonists. It's primarily used as a veterinary sedative and analgesic (pain reliever) for animals, particularly in large animals like horses and cattle. Xylazine works by affecting the central nervous system and producing sedation, muscle relaxation, and analgesia (pain relief). It's not approved for human use, but unfortunately, it has been misused recreationally.

    Usage/Effects: When used illicitly, xylazine is sometimes mixed with other substances, including opioids like heroin or fentanyl. This combination can intensify the effects and potentially lead to unpredictable and life-threatening outcomes. Xylazine is sometimes referred to as a "downer" and is taken to achieve sedation, relaxation, or to enhance the effects of other drugs. However, its use is associated with significant risks.


    • Sedation
    • Respiratory Depression
    • Lower blood pressure and heart rate, which can result in dizziness, fainting, and other cardiovascular issues.
    • Impaired Coordination
    • Confusion and Disorientation
    • Nausea and Vomiting
    • Hallucinations
    • Health Risks: The combination of xylazine with opioids or other substances can amplify the risk of overdose, respiratory failure, and even death.

    Overdose: Although xylazine differs from opioids such as fentanyl, it's advisable to administer naloxone in cases of suspected or confirmed overdose due to the strong possibility of opioids, including fentanyl, co-occurring. Naloxone doesn't counteract the effects of xylazine by itself, and regrettably, there isn't a specific antidote available for it.

Salvia Divinorum

    Classification Salvia divinorum is a hallucinogenic herb of the mint family. The drug comes in three forms: live plants, dried leaves and liquid extract. Extracted and dried leaves are widely available over the internet. Plants are available at nurseries and can be grown easily as potted plants or in the ground.
    Usage/Effects Salvia divinorum can be ingested by chewing and swallowing, placing it under the tongue and smoking it in a pipe or cigarette. The plant is known to have amnesic effects and can cause users to become unconscious or be unable to recall the experience. There are still many unknown effects of Salvia divinorum regarding:
  • Addiction
  • Health problems
  • Smoking risks
  • Overdose
  • Physical dangers

Other Drugs


    Classification Opiates are central nervous system (CNS) depressants derived from the poppy plant. Opiates can also be produced synthetically. The six most common opiates include:
  • Fentanyl
  • Heroin
  • Oxycodone
  • Morphine
  • Codeine
  • Opium

    Opiates are commonly used for medical purposes and also used illegally. Many prescription painkillers on the market contain opiates.

    Methods of taking opiates include:
    • Snorting
    • Smoking
    • Injecting
    • Eating
    Short-term effects include:
    • Itchy skin
    • Impaired vision
    • Altered mental process
    • Overdose/death
    Long-term effects include:
    • Severe weight loss
    • Collapsed veins
    • Lung damage
    • Kidney damage
    • Brain damage
    • Liver damage
    • Immune system damage
    • Death

    Classification Benzodiazepines are depressants and are available as prescription pills, syrup and injectable preparation. These drugs do the following:
    • Cause sedation
    • Induce sleep
    • Relieve anxiety
    • Prevent seizures
    Benzodiazepines can be prescribed as:
    • Valium 
    • Xanax
    • Restoril
    • Ativan
    • Klonopin
    • Other
    Usage/Effects Benzodiazepines are typically taken orally or crushed and snorted.
    Effects include:
    • A calm feeling
    • Euphoria (the high)
    • Vivid or disturbing dreams
    • Amnesia
    • Hostility
    • Irritability

    Overdose may be fatal. Signs of overdose include:
    • Shallow respiration
    • Clammy skin
    • Dilated pupils
    • Weak and rapid pulse
    • Coma
Counterfeit Pills

    Classification Counterfeit pills are fake medications that have different ingredients than the medications these pills are meant to imitate. Counterfeit pills may contain no active ingredient or the wrong active ingredient or contain the right ingredient in the wrong amount. Classification can be difficult without laboratory testing because it is unclear which ingredients the pills contain.

    Counterfeit pills may contain lethal amounts of fentanyl or methamphetamine and are extremely dangerous because they often appear identical to legitimate prescription pills. Users are also likely unaware of how lethal counterfeit pills can be.
    Usage Counterfeit pills are generally consumed orally, crushed and snorted nasally, or mixed with other substances and injected intravenously.
    Distributors in the U.S sell counterfeit pills on social media, appealing to a younger audience using these platforms. Minors and young adults experimenting, as well as regular substance users, believe they are buying:
  • Authentic oxycodone
  • Adderall
  • Xanax
  • Other medicines
However, these people unwittingly buy counterfeit pills that contain lethal amounts of drugs, usually fentanyl and methamphetamine.

K2/Spice and Blue Lotus (Synthetic Cannabinoids)

    Classification Synthetic cannabinoids are part of a group of drugs called new psychoactive substances (NPS). NPS are unregulated, mind-altering substances that are newly available on the market and intended to produce the same effects as illegal drugs. Some of these substances have been around for years but have reentered the market in altered chemical forms or due to renewed popularity.

    K2/Spice is often made of a base of botanical herbs, including blue lotus (a psychoactive plant). The flower’s psychoactive effects are most often attributed to two alkaloids: apomorphine (a sedative) and nuciferine (an antipsychotic).

    Synthetic cannabinoids can come in many forms including:
  • Extracts
  • Resins
  • Dried leaves
  • Oils
  • Powders
  • Electronic cigarette refill liquids (e-liquids)
Synthetic cannabinoids are often sold as natural sedatives/aphrodisiacs, but are not approved by the Federal Drug Administration (FDA) and are deemed illicit by the DOD.

    Usage/Effects The most common way to use synthetic cannabinoids is to smoke the dried plant material. Users also mix the sprayed plant material with marijuana or brew it as tea. Other users buy synthetic cannabinoid products such as liquids to vaporize in e-cigarettes.
    Synthetic cannabinoids is typically consumed by drinking it in teas and dissolving it in beverages that contain ethanol because the alkaloids apomorphine and nuciferine are not water soluble and cannot be smoked or vaped in e-cigarettes.
    The effects of synthetic cannabinoids are often like K2/Spice, but in higher doses it can cause:
  • Intense euphoria
  • Hallucinations
  • Altered mental status (e.g., confusion, anxiety, paranoia)
  • Slurred speech
  • Drowsiness
  • Chest pain
  • Increased heart rate

    Classification Cocaine is classified as a central nervous system (CNS) stimulant. In the early 1900s, it became the main stimulant used in many tonics and elixirs meant to treat a wide variety of illnesses.
    Today, cocaine is a Schedule II drug under the Controlled Substances Act of 1970, meaning it has high potential for abuse. In terms of their chemical composition, powder cocaine and crack cocaine are virtually indistinguishable, resulting in comparable effects. Nevertheless, the administration methods for these drugs differ. Powder cocaine can be snorted, injected, or ingested, whereas crack cocaine is typically smoked. As a result, crack cocaine tends to be more affordable, acts more rapidly, and produces a shorter-lasting high compared to inhaling powdered cocaine. The onset of effects and potential harm reduction strategies vary depending on the method of administration.
Cocaine can be taken by:

  • Snorting
  • Boiling in water and injecting
  • Eating
  • Smoking (crack)
Cocaine’s effects appear almost immediately after a single dose. The effects of cocaine include:

  • Decreased appetite
  • Increased body temperature
  • Increased heart rate
  • Dilated pupils
  • Nausea/vomiting
  • Severe nose damage (when snorted)
  • Kidney failure
  • Seizure
  • Stroke
  • Heart attack

    Classification MDMA is a Schedule I drug under the Controlled Substances Act, meaning it has a high potential for abuse, no accepted medical use in treatment in the U.S. and a lack of accepted safety for use under medical supervision.
    MDMA is known among users as ecstasy. However, researchers have determined that many ecstasy tablets contain not only MDMA but also other drugs or drug combinations that can be harmful, such as:
  • Methamphetamine
  • Ketamine
  • Cocaine
  • Cathinones
  • Caffeine
    Usage/Effects MDMA use involves swallowing tablets, which are sometimes crushed and snorted, occasionally smoked, but rarely injected. It is also available as a powder.
    MDMA is considered a “party drug.” As with many other drugs people misuse, MDMA is rarely used alone. It is common for users to mix MDMA with other substances such as alcohol and marijuana.
    MDMA alters the serotonin system in the brain and could cause long-term damage. People who use this drug experience many of the same effects and face many of the same risks other stimulants such as cocaine and amphetamines present, including:
  • Increased motor activity
  • Alertness
  • Increased heart rate
  • Increased blood pressure
Hallucinogens (including LSD, mushrooms and PCP)

    Classification Hallucinogens are among the oldest known group of drugs used for their ability to alter perception and mood. There was a resurgence of these psychedelic drugs in the 1990s associated with other club drugs and raves. Hallucinogens include:
  • LSD
  • PCP
  • Mescaline
  • Psilocybin
    Usage/Effects Hallucinogens such as LSD are usually consumed orally in one of three ways: in pill form, on a piece of blotter paper or liquid dripped directly on the tongue or on a sugar cube. Mushrooms are typically eaten by themselves, mixed into different food and drinks, or smoked. Physical effects of all hallucinogens include:
  • Extreme sweating
  • Increased heart rate
  • Increased blood pressure
  • Seizures
  • Vivid hallucinations
  • Bad trips (extreme anxiety and despair, along with fears of insanity, death, and losing control)
  • Flashbacks (suddenly and unexpectedly re-experience certain aspects of a previous drug-induced state, even without taking the drug again.)

    Classification Inhalants are invisible volatile substances found in common household products such as:
  • Felt-tip markers
  • Spray paint
  • Air fresheners
  • Typewriter correction fluid
  • Butane
  • Computer cleaners
  • Glue
There are more than 1,000 products that are harmful when inhaled.

    Usage/Effects People breathe in inhalants nasally or huff a soaked rag stuffed into their mouths. Common delivery can be inhaling balloons filled with nitrous oxide, sniffing or snorting the substance from a container or dispenser, or inhaling fumes from a bag.
Effects can include:
  • Slight stimulation
  • Feeling less inhibition
  • Loss of consciousness
  • Damages to sections of brain that control thinking, moving and seeing
  • Slurred speech
  • Loss of coordination
  • Euphoria
  • Dizziness
Long-term use may cause damage to the nervous system and organs. Sudden sniffing death may occur from suffocation or asphyxiation.

Eutylone/Synthetic Cathinones

    Classification Eutylone is a synthetic cathinone with chemical structural and pharmacological similarities to Schedule I and II amphetamines and cathinones, such as MDMA, methylone and pentylone. Evidence indicates people misuse eutylone for its psychoactive effects, just like Schedule I synthetic cathinones.
    A cathinone is a type of chemical compound belonging to the class of amphetamines. It is a naturally occurring stimulant found in the leaves of the khat plant, which is native to East Africa and the Arabian Peninsula. Cathinones are structurally similar to amphetamines and have stimulant effects on the central nervous system.
    Cathinones can also be synthesized in a laboratory, resulting in synthetic cathinones known as "designer drugs" or "bath salts." These synthetic cathinones are often created to mimic the effects of illegal substances such as amphetamines, cocaine, or MDMA (ecstasy). They are typically produced in powder or crystalline form and can be ingested, inhaled, or injected.
    The use of synthetic cathinones has been associated with various health risks and adverse effects, including increased heart rate, elevated blood pressure, agitation, hallucinations, paranoia, and in some cases, severe toxicity or death. Due to their potential for abuse and harmful consequences, many countries have implemented legal restrictions on the production, sale, and possession of cathinones.
    Usage/Effects Users have reported administering eutylone orally, intravenously and nasally. Users report effects that include:
  • Warm tingling sensations
  • Increased focus
  • Changes in vision
  • Euphoria
  • An intense high
In general, synthetic cathinones have been reported to cause adverse stimulant-like effects including:
  • Tachycardia
  • Hypertension
  • Hyperthermia
  • Palpitations
  • Low blood sodium
  • Tremors
  • Seizures
  • Vomiting
  • Sweating
  • Headache
  • Rhabdomyolysis
Bath Salts

    Classification Synthetic cathinones, more commonly known as bath salts, are human-made stimulants chemically related to cathinone, a substance found in the khat plant. Synthetic cathinones are part of a group of drugs called new psychoactive substances (NPS), which concern public health officials.
    NPS are unregulated mind-altering psychoactive substances with no medical use and are meant to imitate the effects of controlled substances. NPS are introduced and reintroduced into the market in quick succession to dodge or hinder law enforcement from addressing the manufacture and sale of these substances.
    Synthetic cathinones are marketed as inexpensive substitutes for other stimulants such as methamphetamine and cocaine, and products sold as molly (MDMA) that often contain synthetic cathinones.
    Usage/Effects Methods people use to consume bath salts include:
  • Swallowing
  • Snorting
  • Smoking
  • Injecting
Synthetic cathinones can produce effects that include:
  • Paranoia: extreme and unreasonable distrust of others.
  • Hallucinations: experiencing sensations and images that seem real but are not.
  • Increased friendliness.
  • Increased sex drive.
  • Panic attacks.
  • Excited delirium: extreme agitation and violent behavior.
Amphetamines (Including Methamphetamine)

    Classification Amphetamines are classified as central nervous system (CNS) stimulants. People use amphetamines for medicinal and illicit purposes. Amphetamines can be divided into three basic groups:
  • Amphetamines (Benzedrine)
  • Dexamphetamines (Dexedrine)
  • Methamphetamines (Methedrine)
This group includes prescription CNS drugs commonly used to treat attention deficit hyperactivity disorder (ADHD) in adults and children. Amphetamines are also used to treat symptoms such as traumatic brain injury and the daytime drowsiness symptoms of narcolepsy. People also use the drug illegally as a recreational drug and as a performance enhancer.

    Usage/Effects There are several methods of consuming amphetamines that include:
  • Orally: pill or tablet form
  • Injection: liquid form into the blood stream or muscle tissue
  • Smoking
  • Snorting
Snorting can cause severe damage to the interior and exterior of the nose.

The effects of amphetamines vary from short-term to long-term usage. Short-term effects include:
  • Dilated pupils
  • Decreased appetite
  • Tremors
  • Loss of consciousness
Long-term effects include:
  • Malnutrition
  • Chronic psychosis
  • Chronic anxiety/tension
  • Brain damage

    Classification Anabolic steroids are any drug or hormonal substance chemically and pharmacologically related to testosterone, which promotes muscle growth. A limited number of anabolic steroids have been approved for medical and veterinary use. People also use anabolic steroids in sports, which include:
  • Weightlifting
  • Body building
  • Long-distance running
  • Cycling
Some people claim these drugs give them a competitive edge and improve their physical appearance.

    Usage/Effects People can ingest anabolic steroids in ways that include:
  • Orally in a pill or liquid form
  • Intravenously, injected with a hypodermic needle
  • Topically by applying a gel or cream containing the steroid onto the skin
Short-term effects include:
  • Sore throat
  • Bad acne/rashes
  • Chronic headaches
  • Insomnia
  • Nausea
  • Muscle cramps
  • Bone pain
Long-term effects include:
  • Feminine breasts in men
  • Sterility
  • Brain damage
  • Tumors of the liver
  • Hepatitis
  • Liver cancer
  • Eye infections
  • Kidney disease
  • Enlargement of facial bones
  • Heart attacks
  • Overly aggressive attitude (“roid-rage”)/homicidal rage